SARCOPENIA AND SEVERITY OF NON-ALCOHOLIC FATTY LIVER DISEASE

BACKGROUND

Non-alcoholic fatty liver disease is characterized by deposition of lipids in the hepatic parenchyma exceeding 5% of liver weight in the absence of other conditions, such as viral or alcoholic hepatitis and metabolic disease. Non-alcoholic fatty liver disease is the most common form of chronic liver disease in several countries. In addition to liver complications, recent studies have shown a relation between liver fat and sarcopenia.

OBJECTIVE

Determine the association between sarcopenia and the severity of non-alcoholic hepatic steatosis diagnosed by abdominal ultrasonography.

METHODS

A clinical, cross-sectional study was conducted with a sample of male and female adults (18 to 70 years of age) submitted to ultrasonography for the investigation of non-alcoholic hepatic steatosis. Evaluations were also performed for the determination of upper and lower limb muscle strength. Data analysis was performed with the aid of the SPSS 22.0 program and involved ANCOVA and the Bonferroni post hoc test, with P-value <0.05 considered indicative of statistical significance.

RESULTS

One hundred two patients were submitted to abdominal ultrasonography, 57.8% of whom presented some degree of non-alcoholic hepatic steatosis. The presence and degree of fatty liver infiltration were significantly associated with the sarcopenic index, determined by the ratio between upper and lower limb strength and BMI (P=0.009 and post-test P=0.028 for upper limbs; P=0.006 and post-test P=0.013 for lower limbs).

CONCLUSION

In the present study, an association was found between the sarcopenic index and non-alcoholic hepatic steatosis, with an inversely proportional relation between this index and the severity of fatty infiltration. This finding offers further evidence of the metabolic interaction of the liver, adipose tissue and muscle.

Secular trend of cervical cancer mortality in Brazil and regions

The scope of this study was to describe the secular trend of cervical cancer mortality in Brazil and its various regions from 1980 to 2021. It involved a populational and ecological study, based on data available at the Department of Informatics of the Unified Health System, using codes 180 and C53. Crude rates, age-specific rates, and age-standardized rates were calculated for the Brazilian and world population. The Average Annual Percent Change (AAPC) was obtained by trend analysis using the Joinpoint Regression Program, with a significance level of 0.05 and 95% confidence intervals (95%CI). There were 171,793 deaths from cervical cancer. In Brazil (AAPC -0.3; CI95%-1.0; 0.4), North (AAPC 0.6; 95%CI -0.1; 1.3) and South (AAPC 0.0; 95%CI -0.5; 0.5) the trends were stationary, increasing in the Northeast (AAPC 0.6; 95%CI 0.3; 0.8) and in the Midwest (AAPC -1.3; 95%CI -1.5; -1.1), and decreasing in the Southeast (AAPC -0.9; 95%CI -1.4; -0.5). Regional differences indicate that public policies need to be improved regarding women's access to a health system that offers adequate prevention, screening and treatment through management strategies that include the most vulnerable population.

Prevalência da hiperidrose primária e seu impacto no trabalho de profissionais de saúde

Avaliar a prevalência e o impacto da Hiperidrose Primária (HP) nas atividades laborais de profissionais de saúde de um hospital público referência em urgência e emergência. Trata-se de uma pesquisa transversal, descritiva, exploratória e quantitativa, realizada com profissionais de saúde de um hospital público referência em urgência e emergência do Estado de Sergipe, Brasil. Os instrumentos utilizados foram o questionário critérios de diagnósticos, de qualidade de vida e sobre impacto da HP nas atividades laborais. Empregaram-se os testes Shapiro-Wilk, Kruskal-Wallis e Mann-Whitney. Participaram do estudo 658 profissionais; a prevalência de HP encontrada foi 11%. Dos portadores de HP, 43% relataram apresentar dificuldades durante as atividades laborativas. Todas as atividades laborais no âmbito da saúde foram referidas com limitações na sua execução pelos profissionais avaliados, sendo a mais referida a escrita (88%), seguida da utilização de equipamentos de proteção individual (81%). A HP teve prevalência relevante nos profissionais de saúde com comprometimento negativo importante na sua qualidade de vida e laboral.

Gynaecological cancer incidence and mortality trends in a Brazilian State with medium human development index: A 22-year analysis

OBJECTIVE

This study aimed to analyse trends in incidence and mortality rates of gynaecological cancer (GC) in Sergipe, a medium Human Development Index (HDI) state in northeastern Brazil during 1996-2017.

METHODS

Data were obtained from the Population-based Cancer Registry of Aracaju and Brazilian Mortality Information System database. We included vulvar (VUC), vaginal (VAC), cervical (CC), uterine (UC; C54-C55), ovarian (OC), placental (PC), and unspecified female genital organ cancers. Crude rates, and age-standardised incidence and mortality rates (ASIR and ASMR, respectively) were calculated using a denominator of 100,000 women. We assessed changes in trends using the annual percentage change (APC) and the average APC (AAPC), using the Joinpoint Regression Program.

RESULTS

From 1996-2017, GC ASIR exhibited a declining trend (AAPC: -3.1), while ASMR increased (AAPC: 2.1). CC had the highest ASIR and ASMR over the years, ranging from 11.6 to 34.3 cases and 4.2-9.0 deaths per 100,000, respectively. Annual decreases in ASIR were observed for CC (AAPC: -5.2) and VAC (AAPC: -5.5). OC saw an increase in mortality rates (AAPC: 1.9; 1996-2017), and CC experienced an increase during 1996-2003 (APC: 6.9). VUC displayed a substantial rise in ASMR from 2001 to 2009 (APC: 27.1), followed by a decrease (APC: -11.3). An increase in mortality trends for UC was observed during 1996-2004 (APC: 10.0), while its ASIR remained relatively unchanged over the years.

CONCLUSION

While overall GC incidence trends declined, mortality rates either increased or failed to decrease significantly. Therefore, additional efforts are required to enhance prevention, diagnosis, and treatment strategies, aimed at reducing and managing the burden of GC in the future.

Educational Nursing Intervention in Reducing Hospital Readmission and the Mortality of Patients with Heart Failure: A Systematic Review and Meta-Analysis

(1) Background: Heart failure (HF) represents a public health problem due to its high morbidity and mortality, increased consumption of health resources, prolonged hospitalization, and frequent readmissions. This study was conducted to evaluate the effectiveness of a nursing educational intervention using home visits (HV) combined with telephone contact in reducing hospital readmission and the mortality of patients with HF. (2) Methods: This is systematic review and meta-analysis of randomized controlled trials (RCTs). The databases used were CINAHL, Cochrane, PubMed and SciELO. A gray literature search included Google Scholar, OpenThesis, Clinical trials and reference lists of eligible studies. RCTs of patients diagnosed with HF were included, distributed between the control group (CG) and intervention (IG), in which the IG was submitted to the nursing intervention with HV and telephone contact in association and analyzed the result of readmission and mortality. (3) Results: The search resulted in 2528 articles and, after following steps, 11 remained for final analysis. A total of 1417 patients were analyzed and distributed: 683 in the IG and 734 in the CG. As a primary outcome, the meta-analysis identified a 36% reduction in the risk of readmission [RR 0.64, 95% CI, 0.54−0.75, p < 0.01] and a 35% reduction in mortality in the IG [RR 0.65, 95% CI, 0.50−0.85, p < 0.01]. Heterogeneity was moderate for readmission and homogeneous for mortality. (4) Conclusions: HV and telephone contact are an effective intervention strategy for nurses’ educational practice.